CA-PS Standard. Generated 9/25/2022. ©2022 Council on Accreditation.
2022 Edition

Pregnancy Support Services Definition

Purpose

Individuals who participate in Pregnancy Support Services learn about parenthood, make informed decisions about their pregnancies, stay healthy, and pursue their educational and vocational goals.

Definition

Pregnancy Support Services provide education, counselling, resources, and support to individuals who are pregnant and in need of assistance, consistent with the organization’s mission.
Note: Organizations providing only Pregnancy Options Counselling or Birth Options Counselling will complete: CA-PS 1, CA-PS 2, CA-PS 3, CA-PS 4, and CA-PS 5.

Note: Please see CA-PS Reference List for the research that informed the development of these standards.

Note: For information about changes made in the 2020 Edition, please see the PS Crosswalk.
 
2022 Edition

Pregnancy Support Services (CA-PS) 1: Person-Centered Logic Model

The organization implements a program logic model that describes how resources and program activities will support the achievement of positive outcomes.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.

Logic models have been implemented for all programs and the organization has identified at least two outcomes for all its programs.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,  
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • Logic models need improvement or clarification; or
  • Logic models are still under development for some of its programs, but are completed for all high-risk programs such as protective services, foster care, residential treatment, etc.; or
  • At least one client outcome has been identified for all of its programs; or
  • All but a few staff have been trained on use of therapeutic interventions and training is scheduled for the rest; or
  • With few exceptions the policy on prohibited interventions is understood by staff, or the written policy needs minor clarification.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Logic models need significant improvement; or
  • Logic models are still under development for a majority of programs; or
  • A logic model has not been developed for one or more high-risk programs; or
  • Outcomes have not been identified for one or more programs; or
  • Several staff have not been trained on the use of therapeutic interventions; or
  • There are gaps in monitoring of therapeutic interventions, as required; or
  • There is no process for identifying risks associated with use of therapeutic interventions; or
  • Policy on prohibited interventions does not include at least one of the required elements.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • Logic models have not been developed or implemented; or
  • Outcomes have not been identified for any programs; or
  • There is no written policy or procedures for the use of therapeutic interventions; or 
  • Procedures are clearly inadequate or not being used; or
  • Documentation on therapeutic interventions is routinely incomplete and/or missing; or
  • There is evidence that clients have been harmed by inappropriate or unmonitored use of therapeutic interventions.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • See program description completed during intake
  • Program logic model that includes a list of outcomes being measured
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel

 

CA-PS 1.01

A program logic model, or equivalent framework, identifies:
  1. needs the program will address;
  2. available human, financial, organizational, and community resources (i.e. inputs);
  3. program activities intended to bring about desired results;
  4. program outputs (i.e. the size and scope of services delivered);
  5. desired outcomes (i.e. the changes you expect to see in service recipients); and
  6. expected long-term impact on the organization, community, and/or system.
Examples: Please see the W.K. Kellogg Foundation Logic Model Development Guide and COA’s PQI Tool Kit for more information on developing and using program logic models.

Examples: Information that may be used to inform the development of the program logic model includes, but is not limited to: 
  1. needs assessments and periodic reassessments; 
  2. risks assessments conducted for specific interventions; and 
  3. the best available evidence of service effectiveness.

 

CA-PS 1.02

The logic model identifies client outcomes in at least two of the following areas:
  1. change in clinical status;
  2. change in functional status;
  3. health, welfare, and safety;
  4. permanency of life situation; 
  5. quality of life; 
  6. achievement of individual service goals; and 
  7. other outcomes as appropriate to the program or service population.
Examples: The decisions pregnant individuals make during service delivery may impact the outcomes they can be expected to achieve. For example, individuals who choose to parent their children may use parent education services and, as a result, be better prepared to raise their children. Individuals who decide to plan for adoption may experience satisfaction with their decision as an outcome of service. Other desired outcomes, such as improved health and increased educational attainment, may be relevant regardless of the decisions made about the pregnancy.

Example: Outcomes data can be disaggregated by race or ethnicity to identify and monitor disparities in service provision or effectiveness.
 
2022 Edition

Pregnancy Support Services (CA-PS) 2: Personnel

Program personnel have the competency and support needed to provide services and meet the needs of individuals who are pregnant.

Interpretation

Competency can be demonstrated through education, training, or experience. Support can be provided through supervision or other learning activities to improve understanding or skill development in specific areas.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,  
  • With some exceptions, staff (direct service providers, supervisors, and program managers) possess the required qualifications, including education, experience, training, skills, temperament, etc., but the integrity of the service is not compromised; or
  • Supervisors provide additional support and oversight, as needed, to the few staff without the listed qualifications; or 
  • Most staff who do not meet educational requirements are seeking to obtain them; or 
  • With few exceptions, staff have received required training, including applicable specialized training; or
  • Training curricula are not fully developed or lack depth; or
  • Training documentation is consistently maintained and kept up-to-date with some exceptions; or
  • A substantial number of supervisors meet the requirements of the standard, and the organization provides training and/or consultation to improve competencies when needed; or
  • With few exceptions, caseload sizes are consistently maintained as required by the standards or as required by internal policy when caseload has not been set by a standard; or
  • Workloads are such that staff can effectively accomplish their assigned tasks and provide quality services and are adjusted as necessary; or
  • Specialized services are obtained as required by the standards.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards.  Service quality or program functioning may be compromised; e.g.,
  • A significant number of staff (direct service providers, supervisors, and program managers) do not possess the required qualifications, including education, experience, training, skills, temperament, etc.; and as a result, the integrity of the service may be compromised; or
  • Job descriptions typically do not reflect the requirements of the standards, and/or hiring practices do not document efforts to hire staff with required qualifications when vacancies occur; or 
  • Supervisors do not typically provide additional support and oversight to staff without the listed qualifications; or
  • A significant number of staff have not received required training, including applicable specialized training; or
  • Training documentation is poorly maintained; or
  • A significant number of supervisors do not meet the requirements of the standard, and the organization makes little effort to provide training and/or consultation to improve competencies; or
  • There are numerous instances where caseload sizes exceed the standards' requirements or the requirements of internal policy when a caseload size is not set by the standard; or
  • Workloads are excessive, and the integrity of the service may be compromised; or 
  • Specialized staff are typically not retained as required and/or many do not possess the required qualifications; or
  • Specialized services are infrequently obtained as required by the standards.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • List of program personnel that includes:
    • Title
    • Name
    • Employee, volunteer, or independent contractor
    • Degree or other qualifications
    • Time in current position
  • See organizational chart submitted during application
  • Table of contents of training curricula
  • Procedures or other documentation relevant to continuity of care and case assignment
  • Sample job descriptions from across relevant job categories
  • Documentation tracking staff completion of required trainings and/or competencies
  • Training curricula
  • Caseload size requirements set by policy, regulation, or contract, when applicable
  • Documentation of current caseload size per worker

  • Interviews may include:
    1. Program director
    2. Relevant personnel
  • Review personnel files

 

CA-PS 2.01

Personnel who provide pregnancy counselling are qualified by:
  1. an advanced degree in social work or a comparable human service field and related experience; or
  2. a bachelor’s degree in social work or a comparable human service field and related experience, with supervision by a person with an advanced degree in social work or a comparable human service field.
NA The organization does not provide counselling services designed to help individuals make decisions about their pregnancies.
Examples: Related experience can include: 
  1. experience in pregnancy counselling; 
  2. experience in family and children’s services and training in pregnancy counselling; or 
  3. experience in counseling and training in pregnancy counselling.

 

CA-PS 2.02

Supervisors of personnel providing education services are qualified by:
  1. an advanced degree in education or a comparable human service field; or
  2. a bachelor’s degree in education or a comparable human service field and two years’ related experience.
NA The organization does not provide education services.

 

CA-PS 2.03

All direct service personnel are trained on, or demonstrate competency in:
  1. counselling and/or supporting individuals who are pregnant and their family members and significant others, including birth fathers;
  2. providing education on topics related to individual functioning, maternal health, and child rearing; and
  3. linking individuals to, and collaborating with, healthcare providers.

 

CA-PS 2.04

All direct service personnel providing education services in a group setting are trained on, or demonstrate competency in:
  1. engaging and motivating group members;
  2. understanding group dynamics;
  3. leading discussions; 
  4. facilitating group activities; and
  5. promoting respectful interactions.
NA The organization does not provide education services in a group setting.

 

CA-PS 2.05

The organization minimizes the number of workers assigned to persons served over the course of their contact with the organization by:
  1. assigning a worker at intake or early in the contact; and
  2. avoiding the arbitrary or indiscriminate reassignment of direct service personnel.

 

CA-PS 2.06

Employee workloads support the achievement of client outcomes and are regularly reviewed.
Examples: Factors that may be considered when determining employee workloads include, but are not limited to:
  1. the qualifications, competencies, and experience of the worker, including the level of supervision needed;
  2. the work and time required to accomplish assigned tasks and job responsibilities; and
  3. service volume, accounting for assessed level of needs of persons served.
 
2022 Edition

Pregnancy Support Services (CA-PS) 3: Intake and Assessment

The organization’s outreach, intake, and assessment practices ensure that persons served receive prompt and responsive access to appropriate services.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • In a few rare instances, urgent needs were not prioritized; or
  • For the most part, established timeframes are met; or
  • Culturally responsive assessments are the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Urgent needs are often not prioritized; or 
  • Services are frequently not initiated in a timely manner; or
  • Applicants are not receiving referrals, as appropriate; or 
  • Assessment and reassessment timeframes are often missed; or
  • Assessments are sometimes not sufficiently individualized; 
  • Culturally responsive assessments are not the norm, and this is not being addressed in supervision or training; or
  • Several client records are missing important information; or
  • Client participation is inconsistent; or
  • Intake or assessment is done by another organization or referral source and no documentation and/or summary of required information is present in case record. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • There are no written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing.  
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Screening and intake procedures
  • Assessment procedures
  • Copy of assessment tool(s)
  • Outreach/informational materials
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

CA-PS 3.01

In an effort to facilitate access to needed services, the organization:
  1. collaborates with other providers, or conducts community outreach, to reach individuals potentially in need of service; and
  2. ensures that its outreach efforts and materials provide an accurate description of the services offered.

Interpretation

If an organization providing counselling offers only Birth Options Counselling and thus does not provide counselling on termination, its outreach materials should clearly convey this fact to potential service recipients.

 

CA-PS 3.02

Persons served are screened and informed about:
  1. how well their request matches the organization's services; and
  2. what services will be available and when.
NA Another organization is responsible for screening, as defined in a contract.

 
Fundamental Practice

CA-PS 3.03

Prompt, responsive intake practices:
  1. gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
  2. give priority to urgent needs and emergency situations;
  3. support timely initiation of services; and
  4. provide for referral to appropriate resources when individuals cannot be served or cannot be served promptly.

 

CA-PS 3.04

Persons served participate in an individualized, culturally, and linguistically responsive assessment that is:
  1. completed within established timeframes;
  2. updated as needed based on the needs of persons served; and
  3. focused on information pertinent for meeting service requests and objectives.

Interpretation

The Assessment Matrix - Private, Public, Canadian, Network determines which level of assessment is required for COA’s Service Sections. The assessment elements of the Matrix can be tailored according to the needs of specific individuals or service design.
 
2022 Edition

Pregnancy Support Services (CA-PS) 4: Service Planning and Monitoring

Each person participates in the development and ongoing review of a service plan that is the basis for delivery of appropriate services and support.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • In a few instances, client or staff signatures are missing and/or not dated; or
  • With few exceptions, staff work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc.; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • In several instances, client or staff signatures are missing and/or not dated; or
  • Quarterly reviews are not being done consistently; or
  • Level of care for some clients is clearly inappropriate; or
  • Service planning is often done without full client participation; or
  • Appropriate family involvement is not documented; or  
  • Documentation is routinely incomplete and/or missing; or
  • Individual staff members work with persons served, when appropriate, to help them receive needed support, access services, mediate barriers, etc., but this is the exception.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.  
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Service planning and monitoring procedures
No On-Site Evidence
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

CA-PS 4.01

An assessment-based service plan is developed in a timely manner with the full participation of persons served, and includes:
  1. agreed upon goals, desired outcomes, and timeframes for achieving them;
  2. services and supports to be provided, and by whom; 
  3. procedures for expedited service planning when crisis or urgent need is identified; and
  4. the individual’s signature.

 

CA-PS 4.02

In an effort to accommodate the unique needs and circumstances of persons served:
  1. pregnant individuals are helped to explore the potential benefits and any concerns about involving family members and significant others, including the birth father, in service planning and provision; and
  2. family members and significant others, including the birth father, are involved in service planning and provision, when appropriate.

Interpretation

 When the birth father or family requests counselling and the pregnant woman is opposed, the organization should either make a referral or create a separate case, as addressed in CA-PS 5.03.

 

CA-PS 4.03

The organization works in active partnership with persons served to:
  1. assume a service coordination role, as appropriate, when the need has been identified and no other organization has assumed that responsibility;
  2. ensure that they receive appropriate advocacy support;
  3. assist with access to the full array of services to which they are eligible; and
  4. mediate barriers to services within the service delivery system.

 

CA-PS 4.04

The worker and a supervisor, or a clinical, service, or peer team, review the case at designated milestones during the pregnancy, or more frequently depending on the needs of persons served, to assess:
  1. service plan implementation;
  2. progress toward achieving service goals and desired outcomes; and 
  3. the continuing appropriateness of the agreed upon service goals.

Interpretation

The organization will define what constitutes a milestone during the pregnancy. When providing Pregnancy Options Counselling or Birth Options Counselling, timeframes for review should be adjusted to reflect the length of time counselling services are offered.

When experienced workers are conducting reviews of their own cases, the worker’s supervisor must review a sample of the worker’s evaluations as per the requirements of the standard.

 

CA-PS 4.05

The worker and individual, and his or her family when appropriate:
  1. review progress toward achievement of agreed upon service goals; and 
  2. sign revisions to service goals and plans.
 
2022 Edition

Pregnancy Support Services (CA-PS) 5: Pregnancy Options Counseling/Birth Options Counselling

Individuals receive nondirective counselling and information services that help them make decisions about the pregnancy.

Interpretation

Organizations that offer counselling on all possible options for the pregnancy (i.e. parenting, adoption or other transfer of custody, and termination) will be considered to provide Pregnancy Options Counselling. Organizations that offer counselling only on parenting and adoption or other transfer of custody (i.e. not on termination) will be considered to provide Birth Options Counselling, and will be rated according to slightly different criteria for standards CA-PS 5.01, CA-PS 5.02, and CA-PS 5.07. See those standards for further guidance.
NA The organization does not provide counselling services designed to help individuals make decisions about their pregnancies.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Outreach materials describing the type of counselling offered
  • Procedures for maintaining confidentiality when involvedparties are counselled separately
  • Procedures for referring individuals to services
  • Informational materials
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 
Fundamental Practice

CA-PS 5.01

Individuals have the option to be counselled and fully-informed about all possible options for the pregnancy.
Interpretation: Possible options for the pregnancy include parenting, planning for adoption or other transfer of custody, and termination. 

When an organization offers only Birth Options Counselling, and thus does not provide counselling and information related to termination, the organization should: 
  1. disclose this fact to service recipients, as referenced in CA-PS 3.01 and CA-PS 3.02; and 
  2. be prepared to demonstrate that it carefully considered its mission, capacity, resources, influence on the individual’s decision making, and community’s needs when it decided not to provide counselling on all alternatives for pregnancy resolution.
When this is the case practice could include providing individuals with a comprehensive list of other community providers that offer pregnancy counselling, support, and education services.

 
Fundamental Practice

CA-PS 5.02

Counselling is nondirective and nonjudgemental, and helps individuals make the best decisions for their particular circumstances.

Interpretation

Although organizations that offer only Birth Options Counselling will not provide counselling on termination, they should still provide nondirective and nonjudgemental counselling regarding parenting and adoption or other transfer of custody.

 
Fundamental Practice

CA-PS 5.03

When family members or significant others, including the birth father, are involved in counselling services:
  1. all parties have opportunities to explore their individual feelings and needs; and
  2. confidentiality is protected at all times, if parties are counselled separately.

Interpretation

When the birth father or family requests counselling and the pregnant woman is opposed, the organization should make a referral or create a separate case. When a separate case is created, confidentiality must be protected at all times.
Examples: When an organization provides joint counselling, it may be appropriate to offer both joint and individual counselling in order to ensure that counselling parties together does not inhibit a full exploration of individuals’ feelings. 

 

CA-PS 5.04

Individuals have the opportunity to receive information and counselling regarding the implications of parenting that addresses:
  1. responsibilities associated with parenting;
  2. child care;
  3. living arrangements;
  4. costs associated with raising a child;
  5. how parenting will impact the expectant parents’ goals and plans for the future;
  6. whether family members or friends will be willing to help the expectant parents;
  7. the role that the birth father will play; and
  8. single parenting or the possibility of marriage.

 

CA-PS 5.05

Individuals have the opportunity to receive information and counselling regarding the implications of adoption or other transfer of custody that addresses:
  1. types of available adoption and guardianship services, and the range of openness in adoption;
  2. parents’ legal rights and the rights termination process;
  3. financial assistance that may be available;
  4. separation from the child, and grief and loss;
  5. long-term implications of the decision; and
  6. making plans for the immediate future.

 

CA-PS 5.06

Individuals have the opportunity to receive information and counselling regarding the implications of termination that addresses:
  1. attitudes toward pregnancy termination, including personal religious beliefs;
  2. emotional issues related to grief and loss, and the finality of the decision;
  3. types of procedures available;
  4. costs of the procedure; and
  5. legal issues for minors (such as parental notification, parental consent, and judicial bypass), if applicable.
NA The organization provides only Birth Options Counselling.

 

CA-PS 5.07

Individuals are helped to carry out their decisions about the pregnancy and obtain any other needed services, directly or by referral.

Interpretation

Individuals may need prenatal care, parent education, adoption services, or termination services to carry out their decisions about the pregnancy. Organizations that offer only Birth Options Counselling, and thus do not provide linkages to termination services, should disclose this fact to service recipients, as referenced in CA-PS 5.01.
Examples: Other needed services can include, but are not limited to, health, educational, vocational, and housing services.

 
Fundamental Practice

CA-PS 5.08

To help individuals stay healthy and prevent subsequent unintended pregnancies, the organization:
  1. provides information and education about the prevention and treatment of diseases, including HIV/AIDS and other sexually transmitted diseases;
  2. provides information and education about pregnancy prevention, pregnancy planning, and the spacing of children; and
  3. links individuals to family planning services.

Interpretation

When an organization does not provide linkages to family planning services because doing so is counter to its mission or beliefs, the organization should disclose this fact to service recipients and provide individuals with a list of other community providers that offer pregnancy support and education services.

Note: When an organization also provides Health Services to expectant parents, the implementation and rating of this standard may overlap with the implementation and rating of CA-PS 6.04.

 
2022 Edition

Pregnancy Support Services (CA-PS) 6: Health Services

Expectant parents are linked to the health services necessary to promote parent well-being, healthy births, and healthy child development.
NA The organization provides only Pregnancy Options Counselling or Birth Options Counselling.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for referring individuals to services
  • Community resource and referral list
  • Informational/educational materials
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 
Fundamental Practice

CA-PS 6.01

Expectant parents are linked to the following healthcare services, as appropriate to their needs:
  1. prenatal health care;
  2. genetic risk identification and counselling services;
  3. labour and delivery services;
  4. diagnosis and treatment of health problems, including sexually transmitted diseases;
  5. dental care;
  6. mental health care, including information, screening, and treatment for postpartum depression;
  7. postpartum care;
  8. ongoing health care, including routine medical checkups; and
  9. paediatric care, including well-baby visits and immunizations.

 
Fundamental Practice

CA-PS 6.02

Expectant parents are helped to access other services needed to promote parental well-being and healthy births, including, as appropriate:
  1. food and nutrition services;
  2. smoking cessation services; and
  3. services for substance use conditions.

 

CA-PS 6.03

Expectant parents are helped to sign up for health insurance when coverage is available and receive information about other options for care, such as free clinics, when insurance coverage is not available.

 
Fundamental Practice

CA-PS 6.04

To help expectant parents stay healthy and prevent unintended subsequent pregnancies, the organization:
  1. provides information and education about the prevention and treatment of diseases, including HIV/AIDS and other sexually transmitted diseases;
  2. provides information and education about pregnancy prevention, pregnancy planning, and the spacing of children; and
  3. links expectant parents to family planning services.

Interpretation

When an organization does not provide linkages to family planning services because doing so is counter to its mission or beliefs, the organization should disclose this fact to service recipients and provide individuals with a list of other community providers that offer pregnancy support and education services.

Note: When an organization also provides Pregnancy Options Counselling or Birth Options Counselling, the implementation and rating of this standard may overlap with the implementation and rating of CA-PS 5.08.

 
2022 Edition

Pregnancy Support Services (CA-PS) 7: Education Services

Educational and skill-building activities help expectant parents gain confidence in their abilities, reach their highest level of personal functioning, experience healthy births, prepare for parenthood, and develop their sense of choice and empowerment.
NA The organization provides only Pregnancy Options Counselling or Birth Options Counselling.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Table of contents of educational curricula
  • Educational curricula and materials
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

CA-PS 7.01

Expectant parents are educated and counselled about positive personal development and self-sufficiency, including:
  1. personal growth and maturity;
  2. interpersonal relations and communication;
  3. future goals and aspirations, including those related to education and employment;
  4. managing and coping with stress, including stress related to the pregnancy;
  5. problem-solving and decision-making;
  6. time, budget, and household management; and
  7. effectively using available community resources.

 

CA-PS 7.02

Expectant parents are educated about the following prenatal health topics:
  1. fetal growth and development;
  2. the importance of prenatal care;
  3. nutrition and proper weight gain;
  4. appropriate exercise;
  5. medication use during pregnancy;
  6. effects of tobacco and substance use on fetal development;
  7. what to expect during labour and delivery; and
  8. benefits of breastfeeding.

Interpretation

These topics may be addressed by qualified medical personnel in the context of the prenatal health care referenced in CA-PS 6.01.

 

CA-PS 7.03

Expectant parents are educated about the following child development and child-rearing topics:
  1. caring for newborns, infants, and young children;
  2. environmental safety and injury prevention, including safe practices for sleeping and bathing;
  3. health and nutritional needs of newborns, infants, and young children;
  4. child growth and development, including physical, cognitive, and social development;
  5. parent-child interactions and bonding; and
  6. age-appropriate behavioural expectations and disciplinary strategies.
NA The organization does not serve expectant parents who plan to parent their children.

 

CA-PS 7.04

Education services:
  1. describe the topics and practices being addressed, and explain why they are important;
  2. model the practices and skills being targeted; 
  3. include opportunities for active engagement and experiential learning, such as coaching and role modelling;
  4. help parents to personalize the information they are taught; and
  5. are provided in a safe environment that does not punish mistakes.

 

CA-PS 7.05

When education is provided in a group setting, participants have opportunities to:
  1. contribute by asking questions and sharing their experiences;
  2. listen to and learn from those who are similar to and different from themselves;
  3. develop positive relationships with others; and
  4. participate in activities of interest.
NA The organization does not provide education services in a group setting.

 

CA-PS 7.06

When education is provided in a group setting, services:
  1. are designed to respond flexibly to the changing needs of group members; 
  2. are scheduled with participants’ time commitments in mind; and
  3. include opportunities for participants to meet individually with personnel, as needed.
NA The organization does not provide education services in a group setting.
 
2022 Edition

Pregnancy Support Services (CA-PS) 8: Promoting Positive Life Course Development

Expectant parents are linked to formal and informal supports and services that can increase self-sufficiency and life options.
NA The organization provides only Pregnancy Options Counselling or Birth Options Counselling.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for referring individuals to services
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

CA-PS 8.01

To promote life options and economic self-sufficiency, expectant parents are helped to locate and enroll in educational or vocational programs that are appropriate to their needs, interests, and abilities.

 

CA-PS 8.02

When current living arrangements are not suitable, expectant parents are helped to find new living arrangements for both during and after the pregnancy.
Examples: Appropriate arrangements can include living: 
  1. independently;
  2. with family members, including the extended family; 
  3. in foster homes;
  4. in group homes; or 
  5. in residential care.

 

CA-PS 8.03

Expectant parents are helped to access other community services needed to support positive life course development, including, as appropriate:
  1. child care;
  2. transportation services;
  3. financial assistance;
  4. legal services; and
  5. domestic violence, sexual abuse, or sexual assault services.

 

CA-PS 8.04

Expectant parents receive social and emotional support directly from personnel and are helped to develop and expand their informal support networks by:
  1. maintaining and strengthening their relationships with family members and the birth father, as appropriate; and
  2. building connections with friends, neighbours, community members, and community institutions.

 

CA-PS 8.05

After delivery, parents without an alternative are helped to place their children in temporary foster care if they need time to establish homes or consider other plans for their children and themselves.
NA The organization does not assist parents in placing their children in temporary foster care.
 
2022 Edition

Pregnancy Support Services (CA-PS) 9: Case Closing and Aftercare

The organization works with persons served and family members, when appropriate, to plan for case closing and, when possible, to develop aftercare plans.
NA The organization provides only Pregnancy Options Counselling or Birth Options Counselling.
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,   
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • In a few instances, the organization terminated services inappropriately; or  
  • Active client participation occurs to a considerable extent; or
  • A formal case closing evaluation is not consistently provided to the public authority per the requirements of the standard.
3
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Services are frequently terminated inappropriately; or  
  • Aftercare planning is not initiated early enough to ensure orderly transitions; or
  • A formal case closing summary and assessment is seldom provided to the public authority per the requirements of the standard; or  
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing. 
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Case closing procedures
  • Aftercare planning and follow-up procedures
  • Relevant portions of contract with public authority, as applicable
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

 

CA-PS 9.01

Planning for case closing:
  1. is a clearly defined process that includes assignment of staff responsibility;
  2. begins at intake; and
  3. involves the worker, persons served, and others, as appropriate to the needs and wishes of the service recipient.

 

CA-PS 9.02

Upon case closing, the organization notifies any collaborating service providers, as appropriate.

 

CA-PS 9.03

If an individual has to leave the program unexpectedly, the organization makes every effort to identify other service options and link the person with appropriate services.

Interpretation

The organization must determine on a case-by-case basis its responsibility to continue providing services to persons whose third-party benefits are denied or have ended and who are in critical situations.

 

CA-PS 9.04

When appropriate, the organization works with service recipients and their family to:
  1. develop an aftercare plan, sufficiently in advance of case closing, that identifies short-and long-term needs and goals and facilitates the initiation or continuation of needed supports and services; or
  2. conduct a formal case closing evaluation, including an assessment of unmet need, when the organization has a contract with a public authority that does not include aftercare planning or follow-up.

 

CA-PS 9.05

The organization follows up on the aftercare plan, as appropriate, when possible, and with the permission of persons served.
NA The organization has a contract with a public authority that prohibits or does not include aftercare planning or follow-up.
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